Him. Davidson et al., Macronutrient preference, dietary intake, and substrate oxidation among stable cirrhotic patients, HEPATOLOGY, 29(5), 1999, pp. 1380-1386
Anorexia in liver disease is common; however, its association with aberrant
metabolism and the type of cirrhosis has not been considered, Dietary inta
ke, nutritional status, fasting substrate oxidation, and macronutrient pref
erence were examined in controls (n = 18) and 65 patients with hepatocellul
ar (n = 31) or biliary cirrhosis (n = 34). Energy intakes were lowest in he
patocellular patients (controls: 9.0 +/- 0.48 megajoules/day compared with
biliary: 7.0 +/- 0.40 MJ/day P < .05; controls compared with hepatocellular
6.5 +/- 0.39 megajoules/day, P < .01), Triceps skinfold was lower only in
hepatocellular patients (controls: 109 +/- 9.2% compared with hepatocellula
r 79 +/- 5.6%, P < .05), The fasting rate of lipid oxidation was elevated i
n hepatocellular patients when compared with controls and biliary patients
(controls: 40.9 +/- 15.1 mg/min compared with hepatocellular 62.8 +/- 16.8
mg/min, P < .001, and biliary : 45.5 +/- 17.0 mg/min compared with hepatoce
llular, P < .001), Control subjects exhibited a greater preference for the
high fat, moderate carbohydrate food (controls: median 7.0 IQR 2.0 compared
with biliary: median 5.0 interquartile range [IQR] 4.7, P < .01) (controls
compared with hepatocellular: median 6.0 IQR 4.0, P < .01), Cirrhotic pati
ents' spontaneous dietary intake is lower than that of controls and recomme
nded intakes. Although macronutrient preference ratings were different with
in cirrhotic patient groups it remains unclear whether associated nutrient
deficits are metabolically driven and dictated by primary cause.